Medicaid's role in financing health care for children with behavioral health care needs in the special education system: implications of the Deficit Reduction Act.
Medicaid's role in financing health care for children with behavioral health care needs in the special education system: implications of the Deficit Reduction Act.
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医疗补助在资助特殊教育系统中有行为保健需求的儿童的保健方面的作用：《赤字减少法案》的影响。
DOI：
10.1111/j.1746-1561.2008.00340.x
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Rosenbaum,Sara
中科院分区：
文献类型：
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作者：
Mandell,DavidS;Machefsky,Aliza;Rubin,David;Feudtner,Chris;Pati,Susmita;Rosenbaum,Sara
背景：最近医疗补助政策的变化可能会对教育系统产生意想不到的后果。本研究通过计算一般学龄儿童和特殊教育儿童的医疗补助报销行为健康保健支出，估计了赤字削减法案 (DRA) 对学区的潜在财务影响。方法：将 2002 年宾夕法尼亚州费城 6 至 18 岁青少年的医疗补助索赔和特殊教育记录合并起来。对参加医疗补助的儿童和未参加医疗补助的儿童的行为保健数量、类型和支出进行了比较结果：参加医疗补助计划 (114,257) 或接受特殊教育 (27,620) 的 126,533 名儿童之间存在显着重叠。 21% 的接受特殊教育的儿童（其中 37% 参加了医疗补助）和 15% 的其他参加了医疗补助的儿童使用了医疗补助报销的行为健康护理。总支出为 1.978 亿美元，其中 40% 用于 5728 名特殊教育儿童，60% 用于 15,092 名其他儿童。结论：医疗补助报销的行为健康服务不成比例地支持特殊教育学生，支出相当于费城 20 亿美元教育预算的 4%。结果表明，特殊教育项目依赖于医疗补助报销服务，而 DRA 可能会危及这些服务的融资。
Background:Recent changes to Medicaid policy may have unintended consequences in the education system. This study estimated the potential financial impact of the Deficit Reduction Act (DRA) on school districts by calculating Medicaid‐reimbursed behavioral health care expenditures for school‐aged children in general and children in special education in particular.Methods:Medicaid claims and special education records of youth ages 6 to 18 years in Philadelphia, PA, were merged for calendar year 2002. Behavioral health care volume, type, and expenditures were compared between Medicaid‐enrolled children receiving and not receiving special education.Results:Significant overlap existed among the 126,533 children who were either Medicaid enrolled (114,257) or received special education (27,620). Medicaid‐reimbursed behavioral health care was used by 21% of children receiving special education (37% of those Medicaid enrolled) and 15% of other Medicaid‐enrolled children. Total expenditures were $197.8 million, 40% of which was spent on the 5728 children in special education and 60% of which was spent on 15,092 other children.Conclusions:Medicaid‐reimbursed behavioral health services disproportionately support special education students, with expenditures equivalent to 4% of Philadelphia’s $2 billion education budget. The results suggest that special education programs depend on Medicaid‐reimbursed services, the financing of which the DRA may jeopardize.